腹腔镜与开放性手术治疗儿童腹股沟疝的对比分析

Comparison analysis of open and laparoscopic procedure for children inguinal hernia

目的比较腹腔镜疝囊高位结扎术与开放性儿童疝囊高位结扎术的优缺点,评价腹腔镜治疗儿童腹股沟疝的临床价值。方法回顾性分析2011年1月至2012年12月,喀什地区第一人民医院收治的腹股沟疝患儿140例,随机分为二组,观察组行腹腔镜下行儿童疝囊高位结扎术,对照组行开放性疝囊高位结扎术。对二组患儿的手术时间、术中出血量、住院时间、切口感染、术后复发等进行比较。结果腹腔镜组在手术时间、术中出血量、住院时间方面优于开放手术组,差异有统计学意义(t=18.404、15.759、14.216,P=0.001 3、0.000 4、0.008 7)。二组患儿在术后并发症比较,差异无统计学意义(χ2=0.497,P=0.481)。结论腹腔镜下儿童疝囊高位结扎术具有操作简捷、对精索损伤小、术后恢复快、并发症少等优点,是治疗儿童疝的微创术式。

Objective To compare the effect of laparoscopic and open high ligation of hernia sac, and to evaluate the value of laparoscopic procedure for＇children inguinal hernia. Methods From January 2011 to December 2012, a total of 140 cases of children inguinal hernia admitted to KaShi First People＇s Hospital were retrospectively analyzed. Patients were randomly assigned to the two groups as observation group and control group in which laparoscopic and open repair were performed respectively. The operation time, blood loss, length of stay, wound infection, hernia recurrence were compared between two groups. Results Laparoscopic group presented superior results in term of the operation time, blood loss and length of stay, and the differences were statistically significant （t = 18. 404, 15. 759, 14. 215, P = 0. 001 3, 0. 000 4,0. 008 7）. While there were no significant differences in complication between two groups （X^2 = 0. 497, P = 0. 481 ）. Conclusions Laparoscopic high ligation of hernia sacis a minimally invasive procedure to children hernia, which has been proved to have the advantages of easy performance, less injury to spermatic cord, rapid recovery and less complications.